WATCHING OVER YOU: Glow Caps fit on ordinary pill bottles that send data to a nightlight containing a cellular modem which sends reports to family, friends, pharmacists and doctors.
At first, Vitality’s business model was to sell the device directly to consumers, through retailers such as Amazon.com, on the Pollyanna-like assumption that patients themselves have the strongest motivation to take care of their own health. But Rose has since learned that pharmaceutical companies and pharmacy service providers such as Express Scripts are willing to shoulder the entire cost. So Vitality is now selling GlowCaps to them, on the theory that they will earn back their investment many times over when patients simply take their medications as prescribed. “We want it to be free to individuals,” says Rose. Under these programs, about 2,000 people are currently using the technology. Vitality aims to have 25,000 users by the end of the year.
Some doctors are skeptical that GlowCaps will do significantly more than other kinds of reminder technologies, such as text messages. “There is convincing evidence that reminders help improve adherence, and innovative ways to deliver reminders are helpful,” says William Shrank, a physician and researcher at Brigham and Women’s Hospital in Boston. “But adherence is a complex behavior, and there are many reasons patients don’t take their meds. It is unrealistic to think that this would eliminate the problem.”
Beyond simply forgetting, patients may fail to take their medications because the drugs or copays cost too much, because they aren’t well informed about why the drugs necessary to treat their illness, or because they simply aren’t engaged in caring for their own health, says Tom Hubbard, who oversees research on medication adherence at the New England Healthcare Institute in Cambridge.
Vitality’s Rose says the technology addresses some of these other problems with its built-in tracking and accountability features; patients get weekly reports detailing how well they’ve followed their prescription, and reports can also be sent to family caregivers or physicians. “If someone is watching and monitoring you, like a report card, people pay attention,” says Kvedar. “If a doctor can say ‘You’re not taking your medication 50 percent of the time,’ I think we’ll see a whole other level [of change].”
Despite research suggesting that these technologies can help, even simple reminder strategies have yet to be implemented on a large scale. “The biggest challenge around adherence is an economic model to sustain it,” says Kvedar. “We need a bigger shift in industry around this problem and who owns it.”